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Study: Excimer laser vision correction improves presbyopic IOL results
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BARCELONA – Using excimer laser vision correction to treat patients with residual refractive error after presbyopic IOL implantation reduces astigmatism and increases visual results, according to a presentation here at the European Society of Cataract and Refractive Surgeons meeting.
“Our results are quite promising for these patients that wanted presbyopic correction. This is not uncommon, and presbyopic IOL results certainly improve with laser vision correction,” David R. Hardten, MD, said.
Fifty-nine eyes with residual refractive error after presbyopic IOL placement underwent excimer laser vision correction with PRK or LASIK. Thirteen eyes received a ReStor IOL (Alcon), 33 received a Crystalens (Bausch & Lomb), 12 eyes received a ReZoom IOL (Abbott Medical Optics), and one eye received a Tecnis multifocal IOL (AMO). Follow-up was at least 3 months (mean 12.2 months).
Overall, mean astigmatism decreased from 1.33 D preop to 0.41 ± 0.42 D at the last postop follow-up. Spherical equivalent decreased from 0.98 ± 0.81 D preop to an average –0.18 ± 0.52 D postop.
Femtosecond laser vs. microkeratome
LASIK flap creation with a femtosecond laser resulted in faster visual recovery and better uncorrected visual acuity compared with microkeratome flap procedures, according to a study conducted on a large series of patients.
A total of 42,143 consecutive eyes with low to moderate myopia and astigmatism were divided into two groups in which the LASIK flap was created with either the IntraLase FS60 femtosecond laser from Abbott Medical Optics or with the Moria Evo3 One-Use Plus microkeratome.
All eyes received a wavefront-guided treatment with a Visx S4 IR Advanced CustomVue excimer laser by AMO.
“The refractive accuracy was the same for both groups, but at all time points, the percentage of eyes that achieved a UCVA of 20/20 or better was significantly higher in the femtosecond laser group than in the mechanical keratome group,” Steven C. Schallhorn, MD, said. “Also, a higher percentage of eyes in the femtosecond laser group achieved a postoperative UCVA of 20/16.”
Less chance of BCVA loss, faster recovery, and a lower rate of complications and enhancements were also reported in the femtosecond laser group.
Femtosecond presbyopia treatment
The new femtosecond laser-based IntraCor treatment for presbyopia is a fast procedure that leads to a significant near visual acuity gain with stable results over a 1-year period, according to a presentation.
“There is high potential for correction of low refractive errors for presbyopic treatment. Since this a noninvasive procedure, it is safe for the patients, and we don’t see any kind of infection, inflammation or weakening of the cornea so far,” Mike P. Holzer, MD, said.
Dr. Holzer presented 12-month follow-up data of the prospective clinical study of the use of the IntraCor procedure (Femtec femtosecond laser, Technolas Perfect Vision) for the treatment of 25 presbyopia patients. The procedure took a mean time of less than 20 seconds, and the nondominant eye was treated in all patients.